Individual
CANDACE L GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LPC
Contact information
Practice address
4514 TRAVIS ST, DALLAS, TX 75205-4112
(214) 526-0742
Mailing address
PO BOX 835840, RICHARDSON, TX 75083-5840
(972) 680-1577
(972) 690-9834
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPCH6915
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5378LC
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/21/2006
Last updated
07/08/2007
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